This is a revised application submitted by Cheryl Dennison, a junior faculty member at the Johns Hopkins University School of Nursing with an appointment in the Johns Hopkins Medicine Center for Innovation in Quality Patient Care. The candidate has a background as a clinician in critical care, is an adult nurse practitioner with preventive cardiology expertise, and has a PhD in nursing. The candidate's goal is to become an independent clinician investigator applying rigorous research methods to develop and evaluate innovative, interdisciplinary methods to improve quality of care for chronic illnesses, such as heart failure (HF). HF is a major public health problem, affecting nearly 5 million Americans in the United States. Its prevalence is expected to double in the United States by 2007. Although HF mortality of 50% over 5 years has recently decreased, HF morbidity is reaching epidemic proportions. HF remains highly prevalent, disabling, and costly in large part due to underutilization of effective therapies despite well-publicized management guidelines. The candidate's proposed career development plan incorporates an interdisciplinary training program designed to provide an intense, closely mentored, research experience in association with structured didactic curriculum. Under the mentorship of senior investigators, Drs. Jerilyn Allen and Peter Pronovost, the candidate will conduct supervised research while concurrently enrolled in advanced coursework in Health Informatics and Decision Support, Quality of Care, Organizational and Provider Behavior Change, and Cost Analysis methodology. The candidate proposes to develop, formatively evaluate, and pilot test an innovative, interactive, Web-based clinical decision support system (CDSS) to improve provider implementation of national evidence-based guidelines and thereby improve quality of care among HF patients. This study, other research projects, and the career development plan described within will prepare this candidate for a successful career as an independent, yet collaborative, investigator strongly socialized in interdisciplinary team science. [unreadable] [unreadable]